Vehicle Final Repair Opportunity Notice Form printable pdf download

FINAL REPAIR OPPORTUNITY NOTICE

This constitutes my notice as a consumer, pursuant to the Georgia Lemon Law, O.C.G.A. Section 10-1-

784(a)(2), that the manufacturer’s authorized agent has been unable to repair or correct the nonconformity

or nonconformities (defects) listed below in the new motor vehicle described below, and that you as the

manufacturer have an opportunity for a final repair attempt.

Defect # 1 _____________________________________________________________________________

Defect # 2 _____________________________________________________________________________

Defect # 3 _____________________________________________________________________________

Defect # 4 _____________________________________________________________________________

Defect # 5 _____________________________________________________________________________

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Vehicle Make _________________________

Model __________________________

Year ___________

Vehicle identification number (VIN

Name/address of selling/leasing dealer_______________________________________________________

______________________________________________________________________________________

Date of delivery _________________

Date registered in GA if bought/leased in another state _________

Odometer reading on delivery date _________________

Current odometer reading _________________

Name/address of facility/facilities where repairs were made and date/s of repairs _____________________

______________________________________________________________________________________

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I am requesting that you make a final attempt to correct the defect(s) reported above. My contact

information is:

Consumer name ___________________________________________ Home phone __________________

Street address ____________________________________________

Cell phone____________________

City/State/ZIP ____________________________________________

Work phone___________________

Consumer signature _______________________________________

Today's date ____ ______________

Instructions to consumer: On this form you should only list defects that have met the required “reasonable

number of repair attempts.” Remember to make a copy for your records and send the original by overnight

mail delivery or certified mail, return receipt requested, to the manufacturer at the address provided

in your owner’s manual. If your vehicle is a motor home, you must send notices to all known

manufacturers.

Also, for our records, please send a copy to the Georgia Department of Law, Consumer Protection Unit at

the address listed on the first page, or fax it to us at 404-656-3569.

Vehicle Final Repair Opportunity Notice Form